A 56-year-old white man with a history of diabetes, hypertension, smoking, and multiple, long-standing, multicolored tattoos obtained a new tattoo on his left forearm with red, black, and yellow pigments. He had a history of 2 basal cell carcinomas (BCCs) of the head and neck. Within 3 weeks of getting this new tattoo, 4 crusted nodules developed within it, ranging in size from 0.6 to 2.6 cm (Figure 1). Biopsy specimens of all 4 lesions indicated keratoacanthomas (KAs), and the lesions were excised. Microscopically, invasive broad tongues of atypical glassy keratinocytes extended into the dermis with tattoo pigment both free in the dermis as well as in scattered histiocytes (Figure 2). No additional tumors developed in the 6 months following surgery.